Organization
BROSNAN DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES GLEN BROSNAN D.D.S. (PRESIDENT)
(708) 952-9185
Entity
Organization
Contact information
Practice address
10522 S CICERO AVE, SUITE 204, OAK LAWN, IL 60453-5200
(708) 952-9185
(708) 952-9186
Mailing address
10522 S CICERO AVE, SUITE 204, OAK LAWN, IL 60453-5200
(708) 952-9185
(708) 952-9186
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
19A12667
IL
Other
Enumeration date
11/03/2006
Last updated
08/22/2020
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